The relationship between hemodialysis modality and insulin resistance in non-diabetic hemodialysis patients

Blood Purif. 2015;39(1-3):224-229. doi: 10.1159/000368882.

Abstract

Background: Although various modalities of hemodialysis (HD) are presumed to have different effects on insulin resistance (IR), the relationship between hemodiafiltration (HDF) and IR has not been fully evaluated.

Methods: In a cross-sectional study, 82 non-diabetic HD patients were enrolled. The patients were divided into two groups according to the median homeostasis model assessment index (HOMA-IR) value of 1.685. Clinical and biochemical data were compared, and multivariate logistic regression analysis was performed to identify the independent factors associated with higher HOMA-IR.

Results: The higher HOMA-IR group had increased body mass index (BMI), decreased HDL cholesterol, and lower beta-2 microglobulin reduction rate (β2-MG RR) compared to the lower HOMA-IR group. HOMA-IR was significantly correlated with β2-MG RR. In addition, HDF patients had lower HOMA-IR levels compared with low flux hemodialysis patients. On multivariate logistic regression analysis, BMI and HDF treatment were independent factors associated with higher and lower HOMA-IR, respectively.

Conclusion: This study suggests that HDF treatment may reduce IR in non-diabetic HD patients.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Blood Glucose / metabolism
  • Body Mass Index
  • Cholesterol, HDL / blood
  • Cross-Sectional Studies
  • Female
  • Homeostasis
  • Humans
  • Insulin Resistance*
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / pathology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Renal Dialysis / methods*
  • beta 2-Microglobulin / blood

Substances

  • Blood Glucose
  • Cholesterol, HDL
  • beta 2-Microglobulin